Objective: There are no data regarding echocardiographic parameters in patients with normocalcemic primary hyperparathyroidism (NCPHPT). Our aim was to compare the echocardiographic findings in postmenopausal women with NCPHPT with those found in patients with hypercalcemic primary hyperparathyroidism (PHPT) and with controls. Methods: Seventeen consecutive Caucasian postmenopausal women with NCPHPT were compared to 20 hypercalcemic PHPT and 20 controls. Obesity, diabetes, kidney failure and previous cardiovascular diseases were considered exclusion criteria. Each patient underwent biochemical evaluation, bone mineral density scan and echocardiographic measurements. Patients with parathyroid disorder underwent kidney ultrasound evaluation. Results: PHPT patients had significantly mean higher total, ionized calcium, 24-hour urinary calcium, PTH and lower phosphorus compared to controls (all p <0.05). The only differences between NCPHPT and PHPT patients were significantly mean lower total, ionized calcium, 24-hour urinary calcium and higher phosphorus in NCPHPT (all p <0.05). The only biochemical difference between NCPHPT and controls was mean higher levels of PTH in patients with NCPHPT. There were no differences in cardiovascular risk factors between NCPHPT, PHPT and controls. Hypertension was the most frequent cardiovascular risk factor, diagnosed in 65% of PHPT patients. This high prevalence was not statistically different compared to that observed in NCPHT (59%) and in controls (30%). Echocardiography parameters were not different between NCPHPT, PHPT and controls subdivided according to the presence of hypertension (ANOVA followed by Bonferroni correction). Conclusions: In a population not at high cardiovascular risk, we found no differences in cardiovascular risk factors and echocardiographic parameters between NCPHPT, PHPT and controls. Abbreviations: NCPHPT = normocalcemic primary hyperparathyroidism, PHPT = hypercalcemic primary hyperparathyroidism, PTH = parathyroid hormone, PTX = parathyroidectomy, CA = total serum calcium, CA++= ionized calcium, P = phosphorus, CR = creatinine, [25(OH)D]= 25-OH-vitamin D, 24-UCa= 24- hour urinary calcium, GFR= glomerular filtration rate, HDL= lower high-density lipoprotein, LVM= left ventricular mass, LVEF= left ventricular ejection fraction LVEDD = left ventricular end-diastolic diameter, IVS= interventricular septum thickness, PWT= posterior wall thickness, LA= transverse diameter of left atrium, EF %= ejection fraction, E/A ratio= early transmitral diastolic flow (E) and flow velocity during atrial contraction (A) ratio, LVMI= left ventricular mass indexed, IVRT= isovolumetric relaxation time, DXA= dual X-ray absorptometry, BMI= body mass index, ANOVA= analysis of variance.
Effect of Surgery on Cardiovascular Risk Factors in Mild Primary Hyperparathyroidism
